How can people be fed equitably, healthily and affordably while maintaining the ecosystems on which life depends? The simple, but not so simple, answer is with a sustainable diet.
Yet this simple two-word phrase has become associated with a variety of meanings. Sustainable is often taken to mean the capacity of the environment to maintain humanity so a sustainable diet, according to this interpretation, is dietary consumption that protects the environment. Yet for a diet to be truly sustainable, it should protect human life and health in its widest sense. This includes protecting populations from diet related disease such as type 2 diabetes and cardiovascular disease, protecting people who work in the food system from poor working conditions and excess use of agricultural chemicals, paying them a living wage, improving local economies and ensuring good animal welfare, as well as protecting the health of the planet. Above all, it means everyone having access to a healthy, affordable diet, that they can obtain with dignity without having to rely on food aid, such as a food bank.
What is a sustainable diet?
Is this a tall order? Maybe it is. But a 2010 report by the FAO & Bioversity basically came up with the same idea, that “Sustainable Diets are those diets with low environmental impacts which contribute to food and nutrition security and to healthy life for present and future generations. Sustainable diets are protective and respectful of biodiversity and ecosystems, culturally acceptable, accessible, economically fair and affordable; nutritionally adequate, safe and healthy; while optimizing natural and human resources.”
Not everyone likes this definition. It’s considered too vague, too hard to achieve, too many trade-offs, and how we can achieve all of that? After all, it’s hard enough to get consumers to change their diets for health. For example, just one in four adults eat the recommended five-a-day for vegetables and fruit. And why are we talking about the need for sustainable diets anyway? Surely we have never had it so good. More people across the world are fed than ever before. The world produces enough food to feed everyone. In the UK and other rich countries food spend accounts for less than 10 per cent of income compared with a third of income 60 years ago.
And yet… during the last 10 years, food banks in Britain have become institutionalised. Between 1st April 2017 and 31st March 2018, The Trussell Trust’s food bank network distributed 1,332,952 three-day emergency food supplies to people in crisis, a 13% increase on the previous year; 484,026 of these went to children. This is a higher increase than the previous financial year, when food bank use was up by 6.64%.
Two thirds of adults, one quarter of children aged 2-10 and one third of youngsters aged 11-15 in the UK are overweight or obese. Treating obesity related conditions is estimated to cost the NHS £5.1 billion a year. The government spend of £5.2 million a year on the Change4Life healthy eating programme is tiny compared with food and drink advertising budgets. In 2017, the top 18 crisp, confectionery and sugary drink brands put £143 million into advertising in the UK. An increasing number of research studies are linking increased intake of ultra-processed food, such as snacks (e.g., biscuits, cakes, confectionery, crisps, soft drinks), sausages, bacon, cheese processed with non-traditional ingredients and some ready to eat meals with increased risk of obesity, type 2 diabetes and cancer.
Diet is associated with significant impact on the environment. Food is a major source of degradation of water, soil and biodiversity, yet we cannot see this. It’s not on a food label. Animal production is responsible for a third of all of agriculture’s greenhouse gas emissions and 36% of the calories produced by the world’s crops are used for animal feed. Only 12% of those feed calories ultimately contribute to the human diet as meat and other animal products. This is not to say that livestock have no place on the planet. Well-managed livestock within integrated farming systems can help to care for the land whilst producing good quality meat and dairy produce. But the increasing demand for meat across the world could likely only be met by intensive farming systems feeding grain to livestock. Diets from such systems are not sustainable. Good diets also require a high amount of horticultural produce yet land use is distorted by feeding ever more animals for meat and dairy. Food waste, which reduces the amount of food available to human beings, also has a significant environmental impact. If global food waste was a country it would be the third largest GHG emitter after the US and China. In the UK food waste was falling but has now stalled.
The problems associated with our diet are well rehearsed but what we can do about them? This is a challenge for sustainable diets. But what would a sustainable diet look like? Basically a sustainable diet is a plant-based diet, which means eating more vegetables, pulses and wholegrains. We need to eat a variety of foods with a rainbow of colours on our plates. We need to buy food from a credible, certified standard, pasture fed, organic, fair trade, and free range. We need to waste less food, moderate our meat consumption (both red and white) and eat fewer foods high in fat, high in salt, sugar and fat. Cooking is important but we need to be careful not to stigmatise and alienate people living in poor circumstances, for whom, fast food, for example, can be a way of gaining time and money. People on low incomes manage their households with dignity and against impossible odds.
Policy makers are not engaging significantly with the need for sustainable diets although the UK’s Eatwell Guide revised in 2016 included more guidance on sustainability than previously, advising the consumption of more plant based protein for example. Eating is, of course, a social activity and in this context Brazil’s dietary guidelines are worthy of special mention. They talk about developing and sharing food preparation skills, preparing food from fresh, healthy ingredients, the importance of regular meal times, eating together, concentrating on your food and not multitasking. They recommend buying food in shops and markets that offer a variety of fresh food, avoiding fast food chains, being critical of food industry advertising, limiting consumption of ready to eat food and drink products, and, in cooking, using fats, oils, salt and sugar in moderation.
Brazil’s approach, which has been endorsed by its Ministry of Health, and survived through recent changes of government, creates a framework for people to eat more healthily, sustainably and to enjoy their food and preparing it. Eating in this way would also send signals to the food system to change what is produced. Because this is what we need: sustainable diets from sustainable food systems.
RSA Fellow Pamela Mason is a Registered Public Health Nutritionist (UK Association for Nutrition) with an MSc in Food Policy. She is an experienced researcher in food and its links with health, the environment, society and the economy.
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As a recently diagnosed diabetic, I know from my own experience that the central thrust of this piece, to eat more plants, is at best misleading. It would make me seriously ill, and I have had to learn differently. And probably more than half the people in the UK are now insulin resistant so that comment applies to the majority.
You helpfully state the point that everyone is agreed on, that processed food has to go, and this is a massive revolution in itself.
There was a conference in London over the weekend #PHCLon2018 where Prof Tim Noakes got the wildest standing ovation for standing up to malicious prosecution over "dietary advice" for four years. His offence was suggesting the babies should not be weened onto carbohydrates.
I hope someone better qualified than I am will pick up this argument, but the FFC is consultative and I am speaking from direct personal experience. I have read the current crop of books and some of the scientific papers.
The Eatwell plate that you mention is without a scientific basis and without merit. At this point given the research it is simply wrong. Its main fault is to recommend that the majority of calories come from carbohydrates. My experience and that of now millions of others is that the majority of calories must come from fat, and that carbohydrate must be limited in my case to 20-30 g per day and probably more generally 50g.
You give a list of processed foods without mentioning bread. Quite a telling omission. I gather "healthy" wholemeal bread is a disaster in giving a glucose and insulin spike.
The other point you make that I suspect is factually wrong, is about animals. Ruminants convert grass and other food humans cannot eat into nutrient dense human food. Taking into account that much of the globe is covered with semi-arid grasslands, I think the argument comes out that in the bigger system we are better off eating animals to save the planet. Taking into account carbon build-up in the soil from properly managed stock the carbon dioxide picture is about neutral.
Of course bad farming is bad farming and factory farming of animals doesn't help any more than sterile monocultures of crops helps. The reintegration of diverse livestock with diverse plant cultivation is the way to feed ourselves and restore soils.
There is much more to question in your article but this is already a long comment.
Hello William,
(I have written a rather long response so am dividing it into several parts. Here is part 1)
Thank you very much for taking the time to read my blog and comment on it. I'm sorry I cannot comment on your individual diet in the context of your diagnosis of diabetes. That would be for your personal GP, practice nurse or dietitian.
On the topic of plant-based, first I think it is helpful to define what is meant by a plant-based diet. It is not a vegan diet or a vegetarian diet though it may share features with both types of diets. The main thing to say is that a plant-based diet need to not be devoid of animal food (meat and dairy) and fish. A plant-based diet consists of vegetables, fruit, whole grains, legumes, nuts and seeds, herbs and spices. A plant-based diet can of course vary in quality from, for example, one consisting of white bread and jam, sweet and savoury snacks high in fat, sugar and salt and perhaps a low nutritional value ready meal or takeaway to one consisting of unprocessed or minimally processed foods such as whole vegetables and fruits (rather than too much juice), whole grain bread (which could include sourdough) beans and pulses, nuts and seeds. The healthiest plant based diet will be one with a large proportion of unprocessed or minimally processed plant based foods.
Hello William,
(I have written a rather long response so am dividing it into several parts. Here is part 1)
Thank you very much for taking the time to read my blog and comment on it. I'm sorry I cannot comment on your individual diet in the context of your diagnosis of diabetes. That would be for your personal GP, practice nurse or dietitian.
On the topic of plant-based, first I think it is helpful to define what is meant by a plant-based diet. It is not a vegan diet or a vegetarian diet though it may share features with both types of diets. The main thing to say is that a plant-based diet need to not be devoid of animal food (meat and dairy) and fish. A plant-based diet consists of vegetables, fruit, whole grains, legumes, nuts and seeds, herbs and spices. A plant-based diet can of course vary in quality from, for example, one consisting of white bread and jam, sweet and savoury snacks high in fat, sugar and salt and perhaps a low nutritional value ready meal or takeaway to one consisting of unprocessed or minimally processed foods such as whole vegetables and fruits (rather than too much juice), whole grain bread (which could include sourdough) beans and pulses, nuts and seeds. The healthiest plant based diet will be one with a large proportion of unprocessed or minimally processed plant based foods.
Here is part 4 of my response.
There is much more research to be done on the health impacts of plant-based vs omnivorous diets (OK every scientist says this!). It is also important to distinguish between healthy and less healthy plant-based diets. Research to date suggests that it is a healthy plant based diet (as described above) where the majority of health befits are to be gained.
Research is also beginning to look at the issue of animal protein vs plant-based protein (rather than just animal fat vs plant food fat) and whilst the mechanisms by which a healthy plant-based diet are linked with good health outcomes are complex, the protein source could be important.
On the topic of meat and livestock farming, I did make the point in my blog that I was not saying there is no room for livestock on the planet and no room for meat in the diet. I did mention the importance of integrated farming and some experts use the term "ecological leftovers" to apply to keeping livestock on land that will not grow crops. A key issue for livestock farming is the need to reduce reliance on feeding grain to animals as this takes up so much land that could be used to feed human beings directly rather than indirectly through livestock that convert the grain to meat. This is, as I mentioned in my blog, inefficient.
Finally, dietary guidelines: most people who are aware of dietary guidelines are aware that the population is not following them, for example, not eating the recommended amounts of vegetables and fruit. If dietary guidelines are not followed, it does not make them wrong. A recent initiative called Peas Please is working to get more vegetables into the UK diet, working with retailers on in-store vegetable promotions and encouraging food service to put more vegetables into its foods and meals. Changing diet is difficult as it may mean changing entrenched habits of many years. Eating is a social and cultural experience and it is the culture around food that needs to change. Marketing of less healthy foods and drink, as I mentioned in my blog, also does not help people to make healthy dietary changes.
With regard to sustainable dietary guidelines, I argue that we should be developing them. What we eat influences our health, the health of the environment we all share, the well-being of animals and the pay received and conditions experienced by people who work in the food system. Changing our global societal reliance on meat-based farming to a more mixed agrarian system based on plants but which would include animals, has many ecologic benefits. It results in more efficient land use; less greenhouse gas production; less air, soil, and water pollution; less damage to wildlife habitats; and less agricultural water use. But it is not just a matter of changing food production, although this of course will need to change. Consumption will need to change too and sustainable dietary guidelines championed by governments would contribute to dietary change, which would in turn send signals to food producers, manufacturers, retailers and food service. Policy makers need to engage much more and their promotion of sustainable diets would help to signal the need for change across the food system.Thank you again for your comments.
That is a full and helpful reply, thank you. Let me respond briefly.
The Eatwell plate and the NHS based advice I have had as a diabetic indicates more that 50% of my diet should be carbohydrates. I report my personal experience simply to point out that this advice is completely, absolutely and diametrically wrong. Scientifically wrong. Carbohydrates are entirely optional in a diet and my diet should be around 75% fat. As I say I am doing very well - sustainably - on this lifestyle and so are now vast numbers of other people in a similar position.
While we speak of fats, the advice to consume vegetable oils, largely advertised as polyunsaturated, is also deeply wrong and contributing to the current crisis. I eat mostly saturated fats and olive oil. The importance of this is that there is very little chance of avoiding carbohydrates on a diet that is not mainly fat (too much protein is a problem). The narrative about saturated fats causing CVD is a complete myth: the opposite is the truth. "Low fat" is now the name of a crisis situation for doctors and food producers who have not responded to the evidence in 40 years.
I submit this to the FFCC review because farmers going back to producing fat meat and moving away from grains, which has to happen given the health crisis, is exactly the sort of parameter that should be factored in to all your discussions. We are agreed about processed food, but that is the tip of the iceberg.
The historical record concurs. In ancient Egypt and Mesopotamia when people first ate a grain based diet their health and their stature and their brain size decreased dramatically.